The pervasive role of sex mindset: Beliefs about the malleability of sexual life is linked to higher levels of relationship satisfaction and sexual satisfaction and lower levels of problematic pornography use

Effect of pornography use on the sexual satisfaction: a systematic review and meta-analysis

OBJECTIVE

Dissatisfaction with an inividual's sex life is underlying factor that can lead to pornography addiction. The current research aims to understand the relationship between pornography use and sexual satisfaction.

METHODS

The pooled correlation coefficient with 95% confidence interval was calculated using random effects. The meta-regression method was used to examine factors affecting heterogeneity between studies and Egger's test was used to evaluate of publication bias.

RESULTS

41 studies with a total sample size of 70541 participants were included in the meta-analysis. The pooled estimate for the correlation coefficient in total, in male and in female -0.06 (95% CI: -0.09 to -0.02), -0.07 (95% CI: -0.16 to 0.02) and -0.04 (95% CI: -0.08 to -0.01). The pooled estimate of correlation coefficient was -0.04 (95% CI: -0.07 to -0.02) in cross-sectional, -0.12 (95% CI: -0.19 to -0.05) in cohort, 0.00 (95% CI: -0.15 to 0.15) in studies that used self-report questionnaire and -0.06 (95% CI: -0.08 to -0.03) in studies that used online survey. Based on the results of the meta-regression, the publication year was found to have a significant effect on heterogeneity among studies (B = 0.013, p = 0.018). However, study design, age, data collection method, quality score and sample size did not have a significant effect.

CONCLUSIONS

There was a significant negative correlation between pornography and sexual satisfaction and the disaggregation of results by gender also indicated this negative correlation among women. However, the relationship between pornography and sexual satisfaction was not significant in men.

Understanding the Ebbs and Flows of Sexual Desire: A Daily Diary Study on the Temporal Associations Between Dyadic Sexual Desire and Partner Interactions

Sexual desire has often been conceptualized and studied as an individual trait. However, empirical evidence suggests that there is also value in studying it as a state and dyadic construct. Through a daily diary study with a randomized controlled experimental design, we aimed to explore (i) how the roles that partners fulfill in dyadic interactions are associated with daily fluctuations in dyadic sexual desire, (ii) whether these roles can be leveraged to affect sexual desire for one's partner, and (iii) whether effects of partner interactions on dyadic sexual desire vary by gender. In total, 163 mixed-gender couples (N = 326), with a mean age of 30.3 years (SD = 7.95), participated. During 22 consecutive days, participants reported daily on their dyadic sexual desire, as well as on several aspects of their interactions. Couples in the experimental condition additionally received assignments that manipulated their partner interactions. Analyzing our data using Multilevel Modelling techniques for longitudinal dyadic data, we found that daily dyadic sexual desire was associated with what each partner takes, gives, and receives in relation with their affiliation, sexuality and exploration needs. Additionally, women's sexual desire was associated with what their partner reported taking, giving, and receiving during affiliative interactions, and with perceived but not enacted responsiveness to their sexuality and exploration needs. Our results suggest that daily ebbs and flows of sexual desire may be partly explained by temporal changes in interactions between partners, making them possible valuable targets for clinical interventions.

Responsiveness in the Face of Sexual Challenges: The Role of Sexual Growth and Destiny Beliefs

Implicit--or lay--sexual beliefs have been associated with how people respond to sexual challenges in romantic relationships. People who endorse sexual destiny beliefs view a satisfying sex life as the result of finding the right partner and report poorer sexual, relationship, and personal well-being when there are sexual challenges. In comparison, people who endorse sexual growth beliefs view satisfying sexual relationships as requiring hard work and effort to maintain and tend to report high sexual, relationship, and personal well-being even when facing sexual challenges. High sexual responsiveness - being motivated to meet a partner's sexual needs - is associated with maintaining high sexual satisfaction, even when couples face sexual challenges in a relationship. In the current research, we tested whether sexual growth and destiny beliefs are associated with general and sexual responsiveness and whether the associations are moderated by the presence of sexual challenges. Across three (clinical and non-clinical) samples (N = 820) facing different types of sexual challenges (Study 1 (Mage = 31.64, SD = 8.53), clinically low sexual desire; Studies 2 (Mage = 32.63, SD = 10.19) and 3 (Mage = 32.40, SD = 9.31), unmet sexual ideals; Study 3, changes in sex since the onset of the COVID-19 pandemic), we found that sexual growth beliefs were associated with higher sexual responsiveness and perceived partner sexual and general responsiveness, even when couples were coping with sexual challenges, whereas sexual destiny beliefs were not associated with responsiveness, and at times were associated with lower sexual responsiveness and perceived partner sexual and general responsiveness. This research provides initial evidence about how implicit sexual beliefs are associated with sexual and general responsiveness when couples are coping with sexual challenges in a romantic relationship.

Spanish Validation of the Long and Short Versions of the Problematic Pornography Consumption Scale (PPCS and PPCS-6) in Adolescents

Although 1-14% of adolescents may experience problematic pornography use (PPU), psychometrically sound instruments for assessing PPU in Spanish-speaking adolescents are scarce. Given the advantages of the different forms of the Problematic Pornography Consumption Scale (PPCS), the aim of the present study was to assess the psychometric properties of the PPCS and PPCS-6, and to examine associations between PPU and age among boys and girls. Two school-based adolescent samples were recruited in Spain (n = 650; Mage = 16.0 [SD = 1.1]; 50% girls and 50% boys) and Mexico (n1, 160; Mage = 15.8 [SD = 1.1]; 68% girls) to assess the psychometric properties of the PPCS and PPCS-6. Confirmatory factor analysis was applied and convergent and discriminant validity with other measures related to PPU was also tested. The results provided empirical support for the six-factor structure of the PPCS and the one-factor structure of the PPCS-6. Boys with older age showed higher levels of tolerance than girls on the PPCS in both countries. Both the PPCS and the PPCS-6 may be considered valid psychometric instruments for the assessment of PPU in Spanish-speaking adolescents from Spain and Mexico.

Is Spontaneous Sex Ideal? Beliefs and Perceptions of Spontaneous and Planned Sex and Sexual Satisfaction in Romantic Relationships

Sexual satisfaction is critical for relationship quality and people hold lay beliefs (implicit theories) about what makes for satisfying sex. A common belief in Western culture is that spontaneous sex is most satisfying, but this idea has not yet been studied. In pre-registered analyses of two studies - a cross sectional (N = 303 individuals) and a 21-day daily experience study (N = 121 couples) - we found support for two distinct beliefs (spontaneous sex as satisfying; planned sex as satisfying). Across both studies, people held stronger beliefs that spontaneous sex is satisfying compared to planned sex, but stronger spontaneous sex beliefs were only associated with higher sexual satisfaction in Study 1. In Study 1, when people perceived their most recent sexual experience as planned (versus spontaneous), they felt less sexually satisfied, but this was not the case for those who endorsed stronger planned sex beliefs. In Study 2, endorsing stronger planned sex beliefs was associated with a partner's lower sexual satisfaction at baseline. There were no associations between perceptions of the extent to which sex was spontaneous and sexual satisfaction at baseline or in daily life. Future research could test whether beliefs about spontaneity and planning have value in clinical settings.

Associations Between Pornography Use Frequency, Pornography Use Motivations, and Sexual Wellbeing in Couples

Pornography use is prevalent, even among partnered individuals. Although pornography use motivations represent key predictors of sexual behaviors, prior studies only assessed the associations between pornography use frequency and sexual wellbeing, with mixed results. This cross-sectional dyadic study examined the associations between partners' individual and partnered pornography use frequency, motivations, and sexual wellbeing. Self-report data from 265 couples (M_{age_men} = 31.49 years, SD = 8.26; M_{age_women} = 29.36 years, SD = 6.74) were analyzed using an actor-partner interdependence model. Men's greater emotional avoidance motivation was related to their own lower sexual function (β = -.24, p = .004) and greater sexual distress (β = .19, p = .012), while their higher sexual curiosity motivation was related to higher partnered sexual frequency (β = .15, p = .031), their own greater sexual satisfaction (β = .13, p = .022), sexual function (β = .16, p = .009), and lower sexual distress (β = -.13, p = .043). Women's higher partnered pornography use frequency was associated with their own greater sexual function (β = .15, p = .034) and lower sexual distress (β = -.14, p = .012). Additionally, women's higher individual pornography use frequency (β = .33, p < .001) and lower sexual pleasure motivation (β = -.35, p = .002) were associated with higher partnered sexual frequency. No partner effects were observed. Findings highlight that women's pornography use frequency and each partner's motivations might play crucial roles in couples' sexual wellbeing.

Navigating Women's Low Desire: Sexual Growth and Destiny Beliefs and Couples' Well-Being

People's beliefs about how to maintain sexual satisfaction have been associated with how they navigate sexual differences, but research has yet to explore the consequences of these beliefs for couples facing a distressing sexual issue. The current research extends past work on sexual growth beliefs (i.e., the view that sexual satisfaction requires continuous effort to maintain) and sexual destiny beliefs (i.e., the view that sexual satisfaction is the result of natural sexual compatibility with a partner) to couples for whom these beliefs might be especially consequential - those coping with sexual dysfunction. In a dyadic longitudinal study of 97 couples coping with women's clinically significant low desire and arousal, we tested how sexual growth and destiny beliefs are associated with sexual, relationship, and personal well-being. We found that endorsing greater sexual growth beliefs was associated with higher sexual desire for both partners, whereas, with some exceptions, endorsing greater sexual destiny beliefs was linked to lower sexual desire and relationship satisfaction, more conflict, and more depressive and anxious symptoms. However, these effects did not persist one year later. Our findings highlight the implications of sexual growth and destiny beliefs for both couple members when navigating a chronic sexual difficulty.

Hands-off: Feasibility and preliminary results of a two-armed randomized controlled trial of a web-based self-help tool to reduce problematic pornography use

BACKGROUND AND AIMS

Despite problematic pornography use (PPU) being prevalent, no previous study has examined the effectiveness of evidence-based interventions for PPU, using rigorous methods. Using a two-armed randomized controlled trial study design, we examined the feasibility and initial effectiveness of a six-week online PPU intervention.

METHODS

We recruited 264 participants (3.8% women, M age = 33.2, SD = 10.6) who were randomized and assigned to either the self-help intervention (n = 123) or waitlist control condition (n = 141), and completed self-report questionnaires at baseline and after the end of the intervention (six-week follow-up). Multivariable linear regression models were generated and tested on a complete case basis to investigate possible treatment effects. Participants provided quantitative and qualitative feedback regarding the intervention's content and appearance.

RESULTS

Participants evaluated all modules positively in the intervention in general. There were differential dropout rates (89.4% in intervention vs. 44.7% in control group) with an overall follow-up rate of 34.5%. The intervention group reported significantly lower levels of PPU (P < 0.001, d = 1.32) at the six-week follow-up. Moreover, they reported lower pornography use frequency (P < 0.001, d = 1.65), self-perceived pornography addiction (P = 0.01, d = 0.85), pornography craving (P = 0.02, d = 0.40), and higher pornography avoidance self-efficacy (P = 0.001, d = 0.87) at the six-week follow-up.

DISCUSSION AND CONCLUSIONS

The present study was only a first step in rigorous treatment studies for PPU, but the findings are promising and suggest that online interventions for PPU might help reduce PPU in some cases, even without the guidance of therapists, by reducing treatment barriers.

Predictors of Sexual Satisfaction in Women: A Systematic Review

INTRODUCTION

The increasing research interest in sexual satisfaction corresponds to a large amount of studies which focus on different singular determinants without establishing a common model for its explanation.

OBJECTIVES

The purpose of this review is to systematically identify and evaluate the structure and results of the current research about sexual satisfaction in heterosexual women in a long-term relationship.

METHODS

A systematic literature search using Web of Knowledge, ProQuest and PSYNDEX was conducted from January 2004 to October 2019. In total, 1,649 studies published in the last 15 years were extracted from the databases with a systematic keyword search. Through a multistage evaluation process 204 studies met the inclusion criteria and described findings about sexual satisfaction as dependent variable.

RESULTS

Research interest in sexual satisfaction increased notably in the last 5 years. Empirical analyses were predominantly based on data from North America whereas a considerably smaller share of research analyzed samples from Europe or Asia. Relationship variables were the most frequently analyzed predictors and included in more than half of the identified studies. Sexual behavior was most often analyzed in the form of frequency of sexual interactions. Contrariwise, sexual practices, communication about sexuality and sexual desire, and sexual thoughts received limited attention. Demographics were considered in one third of all studies. The inclusion of control variables was rare. Some important studies considered variables closely related to sexual satisfaction such as sexual dysfunction.

CONCLUSION

Relationship satisfaction and the frequency of sexual interactions are identified as the most frequently confirmed predictors of sexual satisfaction across all evaluated studies. Results about the effects of pornography consumption, religion, and relationship duration showed the greatest inconsistency. In general, identified effects were often believed to result from mediator variables like sexual desire or distracting thoughts. Rausch D, Rettenberger M. Predictors of Sexual Satisfaction in Women: A Systematic Review. Sex Med Rev 2021;9:365-380.

The Short Version of the Problematic Pornography Consumption Scale (PPCS-6): A Reliable and Valid Measure in General and Treatment-Seeking Populations

To date, no short scale existed that could assess problematic pornography use (PPU) having a solid theoretical background and strong psychometric properties. Having such a short scale may be advantageous when scarce resources are available and/or when respondents' attention spans are limited. The aim of the present investigation was to develop a short scale that can be utilized to screen for PPU. The Problematic Pornography Consumption Scale (PPCS-18) was used as a basis for the development of a short measure of PPU (PPCS-6). A community sample (N₁ = 15,051), a sample of pornography site visitors (N₂ = 760), and a sample of treatment-seeking individuals (N₃ = 266) were recruited to investigate the reliability and validity of the PPCS-6. Also, its association was tested to theoretically-relevant correlates (e.g., hypersexuality, frequency of masturbation), and a cutoff score was determined. The PPCS-6 yielded strong psychometric properties in terms of factor structure, measurement invariance, reliability, correlated reasonably with the assessed variables, and an optimal cutoff was identified that could reliably distinguish between PPU and non-problematic pornography use. PPCS-6 can be considered as a short, reliable, and valid scale to assess PPU in studies when the length of a questionnaire is essential or when a brief screening for PPU is necessary.

Properties of the Problematic Pornography Consumption Scale (PPCS-18) in community and subclinical samples in China and Hungary

Several scales assessing problematic pornography use (PPU) are available. However, in most previous studies, primarily nonclinical and Western samples were used to validate these scales. Thus, further research is needed to validate scales to assess problematic pornography use across diverse samples, including subclinical populations. The aim of the present study was to examine and compare the psychometric properties of the PPCS-18 in Hungarian and Chinese community samples and in subclinical men. A sample of Chinese community men (N1 = 695), a sample of subclinical men who were screened for PPU using the Brief Pornography Screen (N2 = 4651), and a sample of Hungarian community men (N3 = 9395) were recruited to investigate the reliability and validity of the PPCS-18. Item-total score correlation, confirmatory factor analyses, reliability, and measurement invariance tests showed that the PPCS-18 yielded strong psychometric properties among Hungarian and Chinese community men and indicated potential utility in the subclinical men. The network analytic approach also corroborates that the six factors of the PPCS-18 can reflect the characteristic of the participants from different cultural contexts, and participants from community and subclinical populations. In sum, the PPCS-18 demonstrated high generalizability across cultures and community and subclinical men.

Are sexual functioning problems associated with frequent pornography use and/or problematic pornography use? Results from a large community survey including males and females

There is much debate regarding whether pornography use has positive or negative associations with sexuality-related measures such as sexual functioning problems. The present study aimed to examine differential correlates between quantity (frequency of pornography use-FPU) and severity (problematic pornography use-PPU) of pornography use with respect to sexual functioning problems among both males and females. Multi-group structural equation modeling was conducted to investigate hypothesized associations between PPU, FPU, and sexual functioning problems among males and females (N = 14,581 participants; females = 4,352; 29.8%; M_age=33.6 years, SD_age=11.0), controlling for age, sexual orientation, relationship status, and masturbation frequency. The hypothesized model had excellent fit to the data (CFI = 0.962, TLI = 0.961, RMSEA = 0.057 [95% CI = 0.056-0.057]). Similar associations were identified in both genders, with all pathways being statistically significant (p < .001). PPU had positive, moderate associations (β_males=0.37, β_females=0.38), while FPU had negative, weak associations with sexual functioning problems (β_males=-0.17, β_females=-0.17). Although FPU and PPU had a positive, moderate association, they should be assessed and discussed separately when examining potential associations with sexuality-related outcomes. Given that PPU was positively and moderately and FPU negatively and weakly associated with problems in sexual functioning, it is important to consider both PPU and FPU in relation to sexual functioning problems.

Hands-off: Study protocol of a two-armed randomized controlled trial of a web-based self-help tool to reduce problematic pornography use

BACKGROUND AND AIMS

The past-year prevalence of problematic pornography use (PPU) was 1-6% in adult populations. As a result of treatment obstacles and barriers, such as unaffordable treatments, only a minority of problematic pornography users may seek treatment. Having a free, online, self-help program may overcome treatment barriers and may help those individuals who cannot receive traditional or offline treatment for PPU. Although the effectiveness of such online programs reducing substance use and problematic gambling have been reported, no prior study has examined the efficacy of an online self-help intervention aiming to reduce PPU.

METHODS

This two-armed randomized controlled trial (RCT) will examine the effectiveness of an online self-help program (Hands-off) to reduce PPU, while also considering psychopathological comorbidities. The six-week intervention condition includes six core modules developed to reduce PPU based on motivational interviewing, cognitive behavioral therapy, mindfulness, and wise social-psychological intervention techniques. The target sample size is 242 participants. Self-report questionnaires will be administered at baseline, right after the end of the intervention, at one-month, and three-month follow-ups after the end of the intervention. The primary outcome will be the level of PPU. Secondary outcomes will include pornography use frequency, pornography craving, pornography use-avoidance self-efficacy, sex mindset, sexual satisfaction, negative and positive emotions, and life satisfaction. Data will be analyzed on an intention-to-treat basis using linear mixed models.

RESULTS

Results will be reported at conferences and published in a scientific peer-reviewed journal. The participants will be sent a lay-person-friendly summary of the results via e-mail.

A two-study validation of a single-item measure of relationship satisfaction: RAS-1

Research addressing relationship satisfaction is a constantly growing area in the social sciences. The aim of the present investigation was to examine the similarities and differences between the seven-item Relationship Assessment Scale (RAS) and the single-item measure of relationship satisfaction (RAS-1), using proximal and distal constructs as correlates. Two studies using two independent samples were conducted, assessing more proximal constructs, such as love and sex mindset in Study 1 (N = 380; female = 195) and more distant ones, such as loneliness and problematic pornography use in Study 2 (N = 703; female = 360). Structural equation modeling revealed that love (βRAS-1 = .55; p < .01; βRAS = .71; p < .01), sex mindset beliefs (βRAS-1 = .18; p < .01; βRAS = .13; p < .01) and loneliness (βRAS-1 = −.35; p < .01; βRAS = −.37; p < .01) had significant positive and negative associations with RAS and RAS-1, respectively; while problematic pornography use did not. These results suggest that RAS-1 may be an equally adequate instrument for measuring relationship satisfaction as the RAS with respect to proximal and distal correlates. Thus, RAS-1 is recommended to be used in large-scale studies when the number of items is limited.

High-Frequency Pornography Use May Not Always Be Problematic

BACKGROUND

Previously, variable-centered analytic approaches showed positive, weak-to-moderate associations between frequency of pornography use (FPU) and problematic pornography use (PPU). However, person-centered studies are sparse in the literature, and these could provide insight into whether there are individuals who use pornography frequently and do not experience problems or whether there are individuals with comparable high-frequency use who differ on reported experiencing of negative consequences.

AIM

The aims of the present study were (i) to identify profiles of pornography use based on FPU and PPU by applying a person-centered analytic approach and (ii) to examine whether the identified profiles could be distinguished based on theoretically relevant demographic and psychological constructs.

METHODS

Latent profile analyses were conducted on 3 nonclinical samples recruited from general websites and a pornography site (study 1: N = 14,006; study 2: N = 483; study 3: N = 672).

RESULTS

Results were consistent across all studies. 3 distinct pornography-use profiles emerged: nonproblematic low-frequency pornography use (68-73% of individuals), nonproblematic high-frequency pornography use (19-29% of individuals), and problematic high-frequency use (3-8% of individuals). Nonproblematic and problematic high-frequency-use groups showed differences in several constructs (ie, hypersexuality, depressive symptoms, boredom susceptibility, self-esteem, uncomfortable feelings regarding pornography, and basic psychological needs).

CLINICAL TRANSLATION

FPU should not be considered as a sufficient or reliable indicator of PPU because the number of people with nonproblematic high-frequency use was 3-6 times higher than that with problematic high-frequency use. These results suggest that individuals with PPU use pornography frequently; however, FPU may not always be problematic.

STRENGTHS & LIMITATIONS

Self-report cross-sectional methods have possible biases that should be considered when interpreting findings (eg, underreporting or overreporting). However, the present research included 3 studies and involved large community samples and visitors of a pornography website. The present study is the first that empirically investigated pornography-use profiles with a wide range of correlates using both severity of PPU and FPU as profile indicators on specific and general samples.

CONCLUSION

The present study is a first step in the differentiated examination of pornography-use profiles, taking into consideration both PPU and FPU, and it provides a foundation for further clinical and large-scale studies. Different psychological mechanisms may underlie the development and maintenance of FPU with or without PPU, suggesting different treatment approaches. Therefore, the present results may guide clinical work when considering reasons for seeking treatment for PPU. Bőthe B, Tóth-Király I, Potenza MN, et al. High-Frequency Pornography Use May Not Always Be Problematic. J Sex Med 2020;17:793-811.

Revisiting the Role of Impulsivity and Compulsivity in Problematic Sexual Behaviors

Impulsivity and compulsivity are transdiagnostic features associated with clinically relevant aspects of psychiatric disorders, including addictions. However, little research has investigated how impulsivity and compulsivity relate to hypersexuality and problematic pornography use. Thus, the aims of the present study were to investigate (a) self-reported impulsivity and compulsivity with respect to hypersexuality and problematic pornography use and (b) the similarities and possible differences between hypersexuality and problematic pornography use in these domains. Utilizing structural equation modeling (SEM) in a large community sample (N = 13,778 participants; female = 4,151, 30.1%), results indicated that impulsivity (β = .28, β = .26) and compulsivity (β = .23, β = .14) were weakly related to problematic pornography use among men and women, respectively. Impulsivity had a stronger relationship (β = .41, β = .42) with hypersexuality than did compulsivity (β = .21, β = .16) among men and women, respectively. Consequently, impulsivity and compulsivity may not contribute as substantially to problematic pornography use as some scholars have proposed. On the other hand, impulsivity might have a more prominent role in hypersexuality than in problematic pornography use. Future research should examine further social and situational factors associated with problematic pornography use.

Association Between Specific Internet Activities and Life Satisfaction: The Mediating Effects of Loneliness and Depression

The current study examined the associations between specific Internet activities (online shopping, pornography use, social networking site use, and Internet gaming), life satisfaction, and the mediating effects of loneliness and depression for these associations. Participants were 5,215 students (2,303 male participants, Mage = 16.20 years; ranging in age from 10 to 23 years) from various school types (546 elementary school students, 1710 junior high school students, 688 senior high school students, and 2271 university students) who provided self-report data on demographic variables, online shopping, pornography use, social networking site use, loneliness, depression, and life satisfaction. The results indicated that after controlling for demographic variables (gender and age) (a) loneliness and depression had fully positive mediating effects on the association between social networking site use and life satisfaction; (b) loneliness and depression played fully negative mediating effects on life satisfaction associations with online shopping, pornography use, and Internet gaming. Therefore, loneliness and depression were the underlying mechanisms that caused life satisfaction to be affected by online shopping, pornography use, social networking site use, and Internet gaming.